title: Infrahepatic inferior vena cava clamping in hepatectomy for tumors involving hepatocaval confluence.
abstract: BACKGROUND
  Massive hemorrhage and the need for blood transfusion carry a high rate of morbidity and mortality after hepatectomy. The aim of this study was to evaluate the safety and potential benefit of infrahepatic inferior vena cava (IVC) clamping in hepatectomy for tumors involving hepatocaval confluence.
  
  
  METHODS
  We conducted a retrospective analysis of 113 consecutive patients who underwent hepatectomy with infrahepatic IVC clamping (n = 60, Group A) and without infrahepatic IVC clamping (n = 53, Group B) as the initial treatment for tumors involving hepatocaval confluence.
  
  
  RESULTS
  In Group A, central venous pressure reduced from 7.6 ± 3.2 to 4.4 ± 2.7 cm H₂O (p < 0.001). Patients in Group A experienced less blood loss (477.3 ± 340.3 vs. 794.5 ± 602.7 mL, p = 0.001), fewer blood transfusion requirements (8.3% vs. 22.6%, p = 0.034), lower postoperative complications (40% vs. 60.4%, p = 0.031), and shorter hospital stay (10.7 ± 2.2 vs. 12.9 ± 4.8 days, p = 0.008) than those in Group B.
  
  
  CONCLUSIONS
  Infrahepatic IVC clamping is generally effective and safe in controlling bleeding during hepatectomy for tumors involving hepatocaval confluence.
authors.affiliation: Department of Special Treatment and Liver Transplantation, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Jiamei
authors.initials: J
authors.lastname: Yang
authors.forename: Chengjun
authors.initials: C
authors.lastname: Sui
authors.forename: Tong
authors.initials: T
authors.lastname: Kan
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.forename: Yanming
authors.initials: Y
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control* / Q000706:statistics & numerical data; D003250:Constriction; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014682:Vena Cava, Inferior